Active NPI
Alan Lloyd Mazer, D.M.D.
- Dentist
- Port Jefferson Station, NY
National Provider Identifier
1992794069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30090
- Practice address
- 140 Terryville Rd
Port Jefferson Station, NY 11776-1330 - Phone
- (631) 473-0666
- Fax
- (631) 473-0679
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30090 | NY | Primary |
Addresses
Primary practice location
140 Terryville Rd
Port Jefferson Station, NY 11776-1330
Mailing address
15 Sandstone LN
Stony Brook, NY 11790-3101
Phone (631) 689-9598
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 19, 2016 through Jan 19, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30090 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1992794069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 SANDSTONE LN",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117903101",
"telephone_number": "631-689-9598",
"fax_number": "631-473-0679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 TERRYVILLE RD",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117761330",
"telephone_number": "631-473-0666",
"fax_number": "631-473-0679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZER",
"first_name": "ALAN",
"middle_name": "LLOYD",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "30090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
- Kenneth Ryan Mataragas, PA-C
- Mather Faculty Medical Affiliates, University Faculty Practice Corp
- Karen Matragrano, NP-C
- Kelly A. Matthews, LPN
- Michele Marie Mayer, N.P., C.N.M.
- Carolina McCalmon, PA-C
- Vittoria A. McCarthy, C.O.T.A.
- Patrick Joseph McCauley III, PSYD
- Carolyn McConville, LPN
- Eileen J McCormick, M.A.,LMHC,CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.